| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $21K | — | $21K | 10.43% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 700 W 47TH ST KANSAS CITY, MO 64112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 8.45% |
| JB & H LLC3 | 8707 E SAGUARDO VIEW PLACE VAIL, AZ 85641 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $34 | $1K | 2.20% |
| BST COMPANIES INC3 Filed as: BST COMPANIES INC. | 319 N CAMERON VIEW PLACE TUCSON, AZ 85745 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $919 | — | $919 | 1.93% |
| KIMBERLY PETERSON3 | 1860 S GOLDSMITH AVE MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $530 | $8 | $538 | 1.13% |
| MARIA VERONICA JARQUE3 | 4744 N PAULINA ST APT 1E CHICAGO, IL 60640 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $325 | $71 | $396 | 0.83% |
| KURZ & VALDEZ BENEFIT ENROLLMENT SO3 Filed as: KURZ & VALDEZ BENEFIT ENROLLMENT | 8601 N BLACK CANYON HWY STE 20 PHOENIX, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $123 | $192 | $315 | 0.66% |
| STEVEN ROBERT KURZ3 | 14640 N 90TH DR PEORIA, AZ 85381 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | $207 | $311 | 0.65% |
| LORENZA TORRES3 | 9636 E PASEO SAN BERNARDO DR TUCSON, AZ 85747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | $5 | $139 | 0.29% |
| PAMELA J WALKER3 Filed as: PAMELA J. WALKER | 7457 PRAIRIE ROAD NE ALBUQUERQUE, NM 87109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | $8 | $107 | 0.22% |
| MARQUEZ BENEFIT GROUP LLC3 | 8601 N BLACK CANYON HWY PHOENIX, AZ 85021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | $5 | $79 | 0.17% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT ECHOLS | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.11% |
| LUISA DE STEFANO3 | 1265 SOUTHWESTERN DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.11% |
| NOAH OROPEZA3 | 5305 N GINNING DR LITCHFIELD PARK, AZ 85340 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $18 | $46 | 0.10% |
| R AND T FIGUEROA LLC3 Filed as: R & T FIGUEROA LLC | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.07% |
| MERKI BENEFITS ADMINISTRATION LLC3 Filed as: MERKI BENEFITS ADMINISTRATION, LLC | 326 VILLA CANTO EL PASO, TX 79920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $19 | $30 | 0.06% |
| DENISE A MAXWELL3 | 3501 W TORANA DR MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $8 | $30 | 0.06% |
| EC BENEFITS INC3 | 8038 S 38TH PL PHOENIX, AZ 85042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.05% |
| LOIS FLEENER3 | 3196 IVORY DRIVE IDAHO FALLS, ID 83401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.05% |
| MARIA GRACIELA PAMANES3 | 5780 MIRA GRANDE DR EL PASO, TX 79911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.04% |
| ANNALISA MARIE KURZ3 | 8601 N. BLACK CANYON HWY PHOENIX, AZ 85201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $8 | $18 | 0.04% |
| DANIEL ROJAS3 | 6680 CABANA DEL SOL EL PASO, TX 79911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| SHAWN JEFFERY WARREN3 Filed as: SHAWN JEFFREY WARREN | 6950 W. ROWEL PEORIA, AZ 85383 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| VANESSA CARRASCO3 | 1282 ZELLIGE ST EL PASO, TX 79928 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| JOSEPH QUINTANA3 | 3022 N 49TH CT PHOENIX, AZ 85018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| PAM ANDERSON & ASSOCIATES INC3 | 130 W 8600 S MIDVALE, UT 84047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| RITA RIBAS3 | 3624 MIMBRES LANE SANTA FE, NM 87507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| STEVE G MONTOYA3 | 23 COUNTY ROAD 22 ESPANOLA, NM 87532 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| PAUL BYNUM3 | PO BOX 12306 TUCSON, AZ 85732 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JILL HUGHES3 | 6510 TAMARA DR SALT LAKE CITY, UT 84129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| G SCOTT COOKE3 Filed as: SCOTT ALLEN BEER | 316 CROCKER STREET, UNIT A TEMPLETON, CA 93465 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 9.88% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $664 | — | $664 | 9.98% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $499 | $217 | $716 | 14.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 CLAIMS PROCESSOR | Float revenue; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Contract Administrator; Other services; Claims processing Service code 12 | — | $83K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 95 | $199K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 84 | $47K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 103 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 230 | $5K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 58 | $48K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 230 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.